1. A. A carrier or its credentialing intermediary shall:

   1. (1) Accept the uniform credentialing form as the sole application for a health care provider to become credentialed or recredentialed for a provider panel of the carrier; and
   2. (2) Make the uniform credentialing form available to any health care provider that is to be credentialed or recredentialed by the carrier or credentialing intermediary.

2. B. A carrier may not, for purposes of credentialing or recredentialing, require a health care provider to:

   1. (1) Modify the uniform credentialing form;
   2. (2) Submit additional credentialing forms;
   3. (3) Use any other credentialing form not designated by the Commissioner; or
   4. (4) Submit any additional information not specified by the uniform credentialing form, except as stated in §F of this regulation.
3. C. A carrier may preprint the designated carrier information on the uniform credentialing form.
4. D. A carrier may not deny a uniform credentialing form because the form does not include the designated carrier information of the carrier.
5. E. A carrier may require a health care provider to submit a new Authorization to Release Information and Affirmation page, with an original signature and date, for the purpose of credentialing or recredentialing.
6. F. A carrier that is a managed care organization may require a provider to make the disclosure required by 42 CFR §1002.3.

Authority: Insurance Article, §§2-109 and 15-112.1, Annotated Code of Maryland

Effective date: December 25, 2000 (27:25 Md. R. 2285)

Chapter revised effective December 6, 2007 (34:24 Md. R. 2159)

Regulation .03B amended effective January 20, 2014 (41:1 Md. R. 13)

Regulation .03F adopted effective January 20, 2014 (41:1 Md. R. 13)